Perinatal Implications of Sickle Cell Disease

Abstract

Sickle cell disease (SCD) affects millions of people across the globe. In the United States, approximately 70,000 to 100,000 people have the disease, and 2 million have the sickle cell trait. SCD occurs once in every 500 African American births, and once in 36,000 Hispanic American births. Women with SCD can have more adverse maternal outcomes such as preeclampsia, eclampsia, preterm labor, placental abruption, intrauterine growth restriction, and low birthweight. Providing comprehensive nursing care to women with SCD is a challenge, particularly during labor and birth, with nursing management aimed at attaining healthy birth outcomes while preventing or treating manifestations of the disease. Labor and delivery nurses are responsible for specific knowledge and care practices for these women, including differentiating the pain of sickle cell crisis from contraction pain and monitoring maternal and fetal oxygenation, as oxygenation is jeopardized in laboring sickle cell patients. Intrapartum nursing care also requires vigilance in the need for emergency cesarean birth. Nursing interventions include symptom management, pain management, ensuring patient safety, and educating patients. Coordination of care and clear communication between the members of the healthcare team, patient, and family are essential elements to ensure a positive outcome for perinatal patients with SCD.

Birth Weights in Sickle Cell Disease Pregnancies: A Cohort Study

“…Affected infants may have impaired growth and/or cognitive development, and in adult life may be susceptible to heart and vascular problems [ 17 ]. Pregnancies in women with SCD are at increased risk of maternal mortality, pre-eclampsia, preterm delivery and stillbirth; such complications may prevent the developing foetus achieving its growth potential in utero [ 1 , 2 ].…”

“…Pregnancies in this cohort, however, still carry a greater risk of unfavourable pregnancy outcomes [ 1 ]. The major types of SCD are: Sickle Cell Anaemia (HbSS), Sickle cell-Haemoglobin C disease (HbSC) and Sickle Cell β-Thalassaemia (HbSβthal) [ 2 ]. There is a paucity of data into foetal outcomes for infants born to women with SCD [ 3 ].…”

“…The existing data are based on population-based estimates, which do not adjust for the effect of maternal ethnicity and parity on birth weight [ 6 , 7 ]. The purpose of this study is to determine whether or not infants born to women with SCD are more prone to LWB, SGA and intrauterine growth restriction (IUGR) than infants born to women without SCD [ 2 ]. As far as we are aware, this study is novel in its use of customised birth weight growth charts to accurately investigate the relationship between maternal SCD and birth weight [ 8 ].…”

Sickle Cell Disease in Adults: Developing an Appropriate Care Plan

“…Compared to the average Hgb value of 13.8–17.2 g/dl) for males and 12.1–15.1 g/dl for females (U.S. National Library of Medicine, 2015), an individual with SCD has an average Hgb value of 6–9 g/dl (Howard & Oteng-Ntim, 2012; MacMullen & Dulski, 2011). …”

Detección precoz de anemia de células falciformes por medio de un diagnóstico clínico y radiográfico oral. Reporte de caso / Early Detection of Sickle Cell Anemia by oral Diagnosis and oral Radiographs. Case Report

“…El rápido deterioro de los glóbulos rojos puede causar ictericia (8), así como baja tasa de crecimiento en los niños y pubertad tardía en adolescentes. Todos los pacientes, especialmente lactantes y niños pequeños, son más vulnerables a las infecciones y les resulta más difícil combatirlas una vez que las contraen (9,10).…”